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DSH360137V UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER (Active)
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Main Details
Name
UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER
Subdivision Name
UH Westlake Health Center / Wound Clinic Suite
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360137V
Medicare Provider Number
360137
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/14/2022
Participating Start Date
4/1/2022
Participating Approval Date
1/26/2022
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
University Hospitals
Tricia L Bires, Vice President, Treasury
(216) 767-8708
Primary Contact
University Hospitals Health System
Ryan Rosenthal, Manager of Reimbursement
(216) 767-8138
Addresses
Street Address
960 Clague Rd, STE 2300
Westlake, OH 44145-1582
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating Start Date 10/1/2017,Termination Date 7/1/2021, Reinstatement 4/1/2022
01/18/2022
April 2025
April 2025
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